Pros of ACA Plans

Guarantee Issue Policy & No Pre-Existing Conditions

There are many benefits to having an ACA plan. Take for instance the guarantee issue policy, which can extend to any eligible applicant regardless of health status. This means no matter what disease the patient might have, whether that’s HIV, aids, cancer, or diabetes, they will still be able to receive coverage. Pre-existing conditions goes hand-in-hand with the guarantee issue. The ACA will cover you no matter what condition you might have as long as you have coverage under an ACA plan.

10 Essential Benefits

Also, we have the 10 essential benefits package, which is a set of 10 categories of services that health insurance plans must cover under the Affordable Care Act. Some of those services include maternity coverage, substance abuse, alcohol abuse, emergency services, prescription drug plans, and more.

Premium Tax Credits & Cost Sharing Reductions

The ACA has advanced premium tax credits to help make the prices of the ACA cheaper. This is for people that are within 400 percent of the federal poverty level. They actually can get taxes advanced to them so they are able to bring down their premium. I’ve seen people cut their bills in half by using this tax credit to lower their premiums. You know for people that are within 250 percent of the federal poverty level we can actually give them cost sharing. Cost sharing is different from the premium tax credits because it gives you a discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. Depending on how close you are to the federal poverty level it will be adjusted accordingly.

Cons of ACA Plan

ACA Open Enrollment & Price

The biggest problem with ACA is the Open Enrollment Period (OEP); that is the only time when you can enroll in an ACA plan. This 2018 plan year will only last for 6 weeks. OEP is going from November 1st through December 15th and that’s it. The other big problem with the ACA is the price. It isn’t affordable for most people. The cost for ACA can be more expensive than someone’s house, vehicle, or even both combined. Most people can’t afford to get an ACA plan without the advanced tax credits or the cost sharing.

Market Competition & Very Few Providers

You may have heart that these insurance companies have lost hundreds of millions of dollars and have exited the market place, creating no market competition. In a majority of the states and a majority of the counties, you’re stuck with only 2 options. There are very few counties that have more than two options now. What is also becoming a bigger problem is the providers. Since a lot of these companies know they can’t make money offering PPO (large national networks) plans, they have shrunk down to HMO (local networks) plans. There are very few providers accepting ACA plans. So we got a lot of people getting ACA coverage, but doctors are only taking a small percentage of patients. This makes it harder to find a doctor who will see you. It could take months in advance to schedule a doctor’s appointments.

Tune in tomorrow for the completion of our 2 part video! We will compare the pros and cons of the short term health insurance.